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Self-Assessment Questions

Internal Medicine

Perioperative Medicine: Review Questions

Mark A. Marinella, MD, FACP, CNSP
Dr. Marinella, is an assistant clinical professor, Department of Internal Medicine, Wright State University School of Medicine, and a practicing hospitalist, Miami Valley Hospital, Dayton, Ohio.

Choose the single best answer for each question.

1. A 65-year-old man with type 2 diabetes mellitus and hypertension presents for preoperative evaluation prior to an elective hip arthroplasty. He has no signs of heart failure or cardiac ischemia. Which of the following agents should be administered preoperatively to decrease the risk of perioperative cardiac morbidity in this patient?
  1. Atenolol
  2. Hydralazine
  3. Minoxidil
  4. Prazosin
  5. Verapamil
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2. Which of the following tests should be routinely obtained in a healthy 40-year-old man before elective laparoscopic cholecystectomy?

  1. Bleeding time
  2. Chest radiograph
  3. Echocardiogram
  4. Serum potassium level
  5. None of the above
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3. A 77-year-old woman with an intertrochanteric hip fracture experiences postoperative delirium. Which of the following is the least likely common cause of postoperative delirium in this patient?

  1. Antiemetic therapy
  2. Calf vein thrombosis
  3. Hyponatremia
  4. Narcotic analgesia
  5. Urinary tract infection
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  4. Which of the following regimens is most effective in preventing venous thromboembolism in patients undergoing open reduction and internal fixation for a trochanteric hip fracture?
  1. Aspirin 325 mg daily
  2. Enoxaparin 5 mg daily
  3. Enoxaparin 40 mg daily
  4. Heparin 5000 U twice daily
  5. Leg elevation
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5. Which of the following is NOT a cause of postoperative hyponatremia in a patient who underwent surgery for a subarachnoid hemorrhage?

  1. Cerebral salt wasting
  2. Diabetes insipidus
  3. Diuretic use
  4. Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
  5. Volume depletion
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